Making a request for sample processing

Listed here is the most frequently needed information. If you cannot find the information you need please contact us.

Requests from OUH staff using the EPR system

For OUH patients the electronic patient record (EPR) should be used to request Clinical Biochemistry tests.

There is information for OUH staff on the OUH intranet for EPR support and training, and for EPR downtime procedures.

Ensure you make the request for the correct patient, and select the correct patient episode. This provides the lab with patient identification (NHS number, hospital number, name and date of birth), patient location and consultant.

• Select '+Add' next to the 'Requests and Prescribing' option from menu on left-hand side of screen.
  
• Search for the appropriate test and click on it to add it. Repeat this for any other required tests. When you have selected all of the required tests select 'Done'.
  
• If you have added a test you do not require, you can right-click on this test and select 'remove' from the list of options in the pop-up box.
  
• Fill in all of the boxes at the bottom of the screen.
  
• Please ensure you provide appropriate clinical details.
  
• Please provide your bleep or contact number so that you can be contacted if there are any problems or results that need to be telephoned.
  
• Confirm the request by clicking 'Sign'.
  
• Label each sample with the label printed via EPR.
  

If you cannot find the test(s) you require then try acronyms / alternative names for the test. If you are still unable to find the required test(s), request the test OTHR-C and enter the required test name and sample type under clinical details (note: do not enter this information under order comments).

Requests from primary care

For patients in primary care in Oxfordshire, SunquestICE™ should be used to request Clinical Biochemistry tests electronically.

Request cards

Where electronic requesting is not available, there is a standard request card suitable for all specimens.

Instructions for completion of the joint Biochemistry / Haematology request form

Instructions

1. Please fill in the patient's full name and date of birth; insufficiently labelled specimens will not be tested. If available, it is acceptable to use addressograph labels on request forms.
   
2. Please use either NHS or hospital number on all requests; it enables the department to link results with previous records on the patient.
   
3. Clinical information is very important, especially for some Biochemistry requests. Please do not leave this blank.
   
4. Please include a patient location on all request cards; it will enable the laboratory to telephone the results if abnormal or if the specimen is unsuitable for testing. For GP patients, please remember to give the requesting GP's name and location, as well as the patient's midwife's name and contact number.
   
5. Please list the tests required, for Haematology and Biochemistry. For information on specimen requirements, please refer to information given in the A-Z list. Please ensure that you have taken sufficient blood for the required tests.
   
6. Please fill in date and time of specimen collection.

Transportation of specimens to the laboratory

Within any of the three sites, specimens may be sent to the laboratory in the Pneumatic System or by portering service.

Transfer from other medical units in Oxford is by vehicles operated by the Oxford ambulance services and a shuttle van between the John Radcliffe and Churchill hospitals.

A once or twice (depending on practice size) a day service to local GPs operates for the collection of specimens, and to deliver reports and equipment for specimen collection at the JR. The Horton is served by a similar service.

If blood or urine samples cannot be transported to the laboratory on the day of collection, please refer to the guidance provided below:

Transport and storage of samples: Best Practice Guideline for Primary Care (pdf, 27 KB)

Specimens for urgent investigation out of core hours should be sent via the best available transport or porter service directly to the Joint Specimen Reception area on Level 4 at the John Radcliffe or to the Horton Pathology laboratories.

All specimens that are transported by these services must be appropriately packaged and labelled. Transport should be organised so as to prevent unauthorised access to specimens.

Guidance notes are available within the Laboratory Medicine Specimen Transport Policy.

For more detailed transport information, please see:

Pathology and laboratories

Patient collected samples

Patients should not be asked to deliver their own samples to Clinical Biochemistry. Outpatient samples should generally be delivered via the GP.

In the event of a patient delivering their own sample, this should be received at specimen reception on Level 4 at the John Radcliffe Hospital or at reception on the ground floor of the Pathology block at the Horton General Hospital.

Please visit Patient collected samples

Consent for testing

It is the responsibility of the requesting doctor to obtain appropriate informed consent for all investigations.

Specimen acceptance criteria

In order for the Clinical Biochemistry department to perform the requested analysis, the following criteria must be met.

• Correctly labelled specimen(s) with at least two different patient identifiers, one of which must be the surname.
• Appropriate specimen(s) and container(s) for the test(s) required.
• Sufficient specimen in the container(s) to perform the tests.
  • Guidance on specimen volume: EPR and ICE requesting are programmed to produce multiple barcodes for the same specimen type to highlight the requirement of multiple tubes collection (e.g. if two EPR labels for biochemistry tests on lithium heparin are printed, then two lithium heparin tubes are required). If unsure, please contact the laboratory.
    
• Specimen(s) received in an appropriate manner / timeframe.
• No conflicting information provided. Examples of conflicting information include:
  • specimen(s) received with a request card where the patient identifiers are different on the card and the specimen(s)
    
  • a specimen bag that contains specimens that are labelled with different patient identifiers.

Labelling specimens

Specimen containers should be clearly identifiable (use a printed sticky label when available). Electronic requests will always generate a sticky label that must be used for these types of request. Please ensure the patient details have been printed correctly on the sticker before attaching it to the specimen.

When making multiple electronic requests, make sure to put the correct label on each sample. Otherwise, the patient's full name and date of birth, NHS and/or hospital number should be clearly written on the container.

Adding an extra request to an existing sample

We may be able to offer further tests on samples already received by the laboratory.

There are certain limitations that apply to all requests:

• Biochemistry samples (serum and heparin) are normally stored for between four and six days, depending on the original tests requested. Samples older than this will have been discarded.
  
• Fluoride samples are normally stored for two days - samples older than this will have been discarded.
  
• Haematology samples are normally only stored for one day - samples older than this will have been discarded.
  
• There may not be sufficient sample left to perform the retrospective analysis.
  
• The sample may have been used for a send away test.
  
• The sample may not meet the specimen requirements for a specific test (stability, protection from light etc.).
  

Procedure for making a retrospective test request with the laboratory:

• Ascertain whether the laboratory has received an appropriate specimen type within the above time window.
• If a valid specimen and suitable test for retrospective testing has been identified, then:
  • for specimens previously analysed at the JR or Churchill laboratories contact: 01865 857791
  • for specimens previously analysed at the Horton contact: 01295 229244
• You will need to state the following information:
  • patient's NHS or hospital number
  • patient's full name
  • date and time of the specimen needing retrospective analysis
  • name(s) of the retrospective tests to be performed on that specimen.

Some tests may be requested retrospectively using EPR.

• Ascertain whether the laboratory has received an appropriate specimen type within the above time window.
• Ensure that the tests required have not already been analysed/requested retrospectively before making the request.
• In EPR, go to 'Requests and Prescribing' and select 'Add'.
• Type in 'Retrospective' to the search box to find the Retrospective Request Careset.
• Select the required tests and click 'Orders for Signature'. If the required test is not available call the lab as described above.
• Enter 'Retrospective’ under Clinical Details, and if necessary, the date of the sample the tests are to be added to. Enter a bleep number and click 'Sign'.
• Check the list of requests under 'Requests and Prescribing' for 'Laboratory' to confirm that the tests have been requested. If the lab is unable to perform the test (sample too old/not suitable/insufficient), a message will appear in the message centre to indicate the problem.
• There is no need to call the lab in addition to requesting through EPR.